[The history of vaginoplasty: Technical and sociological advances]. / Histoire de la vaginoplastie : évolution technique et sociologique.

Technical advances in gender-affirming genital surgery have allowed the modern surgeon to create a vagina, vulva and clitoris from a male sex. This surgery, commonly known as vaginoplasty, should in fact be identified as aidopoiesis, since it is not a question of improving an already existing vagina but of creating a female sex. Numerous technical advances made since 1930 throughout the world now offer a safe and proven surgical strategy for female genital gender affirmation. Most of these techniques are derived from advances in intersex genital surgery. The first vaginoplasties described in the context of gender affirmation were performed in Berlin in the 1930s. After the Second World War, the greatest advances in vaginoplasty were made in Denmark. It was not until Geroges Burou in Casablanca and Harold Gillies, aided by Ralph Millard in England, in the mid-fifties that the modern technique of invagination of the penile skin took over from neo-vaginal grafting techniques. The creation of the clitoris from the glans penis and a more aesthetic vulva were the major advances from the 1970s. Other flap or intestinal transplant techniques were also developed, often to correct the failure of penile skin invagination. Some of the patients who benefited from these early technical advances, such as Lili Elbe and Christine Jorgensen later on, helped to make this surgery, which had long remained taboo, popular with the general public. Pioneers such as the gynaecologist Georges Burou in Casablanca have contributed, with the greatest discretion, to the well-being of gender-affirmed people by improving these techniques. Today, this hard-won heritage cannot be ignored by surgeons interested in vaginoplasty.

What Practice Issues Over 25 Years Most Interest Registered Dietitians? Survey and Interview Results.

Dietetics has changed substantially; a mixed-methods project was undertaken to: (i) gauge interest in the profession history since 1993, (ii) identify preferred format(s), (iii) identify possible topics, and (iv) identify possible key informants. An online bilingual survey was conducted in 2018, with follow-up phone interviews among interested respondents. Survey content was organised as 12 major topics. Respondents were invited via a Dietitians of Canada (DC) newsletter, Facebook groups, and at the DC national conference. Survey data, including respondent-generated topics of interest and interview content, were descriptively analyzed. The online survey garnered 360 responses; 332 (92%) completed more than 10% of the survey and were interested in history. Detailed responses were analyzed (296 English; 36 French); 51 were interviewed. An online timeline was the most preferred format (79%). Review of the rise in technology and obesity, aging, supermarket registered dietitians (RDs), the local/organic movement, Practice-based Evidence in Nutrition (PEN), the changes in training models and scope of practice, public awareness of the profession, and advocacy and unique career paths were of most interest (≥ 50% of respondents). These results confirm interest in the recent history of the profession among RDs and provide guidance on preferred format and topics for further work.

Filling the Gap between Metropoles and Peripheries: Insights about Hospital Standardization from the British Columbia Hospital Association Conferences, 1918-30.

In this study, we examine British Columbia's Hospital Association conference records (1918-31) to understand how place, gender, and profession shaped debates about hospital standardization during the interwar period. The conference records reveal that hospital standardization was conceptualized as the conformity of smaller, peripheral hospitals to larger metropolitan ones. Arguments about how to best address the gaps in small hospitals were often directed to elite nursing leaders, who suggested improved nursing education as a solution. Hospital affiliation was recommended to ensure adequate training for rural nurses by moving trainee nurses from rural to urban hospitals during the last year of their education. Yet the way that affiliation was conceived was more aligned with the professional goals of the nursing elite, rather than the needs of rank-and-file nurses in small hospitals. These ideas ultimately worked to support the goals of standardization, but obscured the divergent needs of small community hospitals.

Medical History Memorialized: The Origins and First Decade of the Canadian Bulletin of Medical History / Bulletin canadien d'histoire de la médecine (1979-94).

In 1979, the Canadian Society for the History of Medicine, founded in Quebec City, Canada, in 1950, inaugurated its first official organizational organ, Newsletter/Nouvelles, which ran for 10 issues in five annual volumes. In 1984, this modest means of institutional communication expanded to become the Canadian Bulletin of the History of Medicine / Bulletin canadien d'histoire de la médecine, a peer-reviewed journal that continues to the present. Central to the founding and operation of both publications was Kenneth B. Roberts of the Faculty of Medicine, Memorial University of Newfoundland. This discussion outlines the foundation, evolution, and activities of both these periodicals from 1979 to 1994. Their relationship to the growth of both the Canadian Society for the History of Medicine and the field of medical history in Canada are also delineated.

[A short history of the concept of bias in epidemiology]. / Une brève histoire du concept de biais en épidémiologie.

BACKGROUND: Bias is a major methodological issue for epidemiology. However, only a few studies have been dedicated to the past and present formulations of the concept of bias. Moreover, the classical definition of bias as systematic deviation from the truth of results or inferences, definition which can be found in dictionaries of epidemiology, does not seem to either match the way epidemiologists use it in practice, or correspond to the different definitions given throughout its history. It is consequently important to elucidate this paradox. METHODS: In this historical and conceptual article, we study the different uses of the word "bias" in epidemiological literature, from classic articles in the 1950's about the link between smoking and lung cancer to the most recent epidemiology textbooks, the objective being to analyze the ways in which epidemiologists have defined, applied and modified this concept over time. RESULTS: We show that D.L. Sackett's article on bias in analytic research, published in 1979, put an end, at least temporarily, to reflection in populational epidemiology that started thirty years before. More precisely, we show that Sackett's definition of bias corresponds more to the needs and goals of clinical epidemiology than to those of populational epidemiology. Concomitantly, populational epidemiologists such as K.J. Rothman redefined bias as a threat to the internal validity of a study, and epidemiological study as an "exercise in measurement of an effect rather than as a criterion-guided process for deciding whether an effect is present or not". CONCLUSION: It is thereby important to draw a distinction between two notions pertaining to bias: an epidemiological concept of bias, viewed as the lack of internal validity of an observational study; and a medical concept of bias, defined as deviation from the truth. The former concerns the design and methodology of epidemiological studies; the latter is more general and impels epidemiologists and physicians to be skeptical, and even critical, towards their own inferences.

The History of Saskatchewan's Public Health Association Policy Initiatives, 1954-86: A Regional Comparison for Preventative Health Policy Work in Canada.

After the Second World War, health prevention work in Canada shifted from a focus on sanitation and hygiene to illness prevention and health promotion. Canada became a significant global leader, beginning with the Lalonde Report of 1974. Yet less is known about the provincial public health associations and how their work differed from that of the national body. The purpose of this article is to examine the Saskatchewan Public Health Association's (SPHA) policy work from 1954 to 1986. Utilizing meeting minutes and newsletters, we found that while both national and provincial associations made efforts to prevent accidents, reduce tobacco use, and fluoridate water, the SPHA tended to advocate more for child health, and the cautious use of nuclear power. At the same time, the SPHA's resolutions tended to ignore emerging factors shaping health, including the social determinants of health, regional inequities, lack of public trust in experts, misinformation, and human psychology. Examining the SPHA's records revealed that region mattered in preventative policy work.

"Unscrupulous and Morally Ill-Prepared" Laymen or Professionals? Controlling Pharmacists during the Brazilian Military Dictatorship.

This article traces the transformation of the system of control and repression of Brazilian pharmaceutical activities between the 1930s and the 1970s, through a Foucauldian framework of "differential management of illegalisms." The period between 1930 and 1960 can be understood as a process of negotiation between pharmacists and state agencies that achieved a compromise on the differential management of illegalisms in relation to drugs, with a clear distinction between "laymen" and "professionals." This compromise came into question during the dictatorship, due to institutional transformations that reinforced the autonomy of institutions of repression and a military struggle against subversion and corruption. Pharmacists and laymen alike were considered potential suspects. This suspicion even extended to the civilian agencies that were at the core of the regulation of the licit drug market. These developments profoundly changed the way illegalisms committed by professionals and state officials were treated, blurring the boundaries that had been established between laymen, professionals, inspectors, and industrialists. The final section of the article focuses on the various ways in which institutions of repression focused on pharmacists and state regulatory control agencies as potential places of subversive activity or corruption.

The Neurological Study Unit: "A Combined Attack on a Single Problem from Many Angles".

In the 1920s, neurology was a fledgling discipline. Various attempts were made to establish programs relating to neurological care and research. One such initiative was the Neurological Study Unit (NSU) at the Yale School of Medicine. My aim is to chronicle the early years of the NSU (1924-40): the motivations for establishing the unit, its structure, its challenges, and its evolution. I have studied all documents related to the NSU at Manuscripts & Archives, Yale University Library. The NSU was heralded as a "combined attack on a single problem from many angles." It was slow to develop, however, and had a number of missing elements. While some of this may have been due to a lack of funds and the absence of a dedicated neurologist, it was also the result of a failure to conceptualize a neurological unit, the slow evolution-into-existence of a nascent and fledgling medical discipline, growing pains and frictions within the leadership, a university-based rather than a hospital-based model of operation, and turf wars between neurology and allied disciplines.

Different Peoples, Different Inebriations: The Recognition of Different Cultures of Intoxication in Early Modern English Medicine.

In early modern Europe, the global dimensions of the drug trade and the introduction of new substances contributed to the development of new cultures of intoxication. This process was particularly evident in England, where a new intoxication culture emerged from the recognition of how different substances produced similar reactions. Medical travel literature provides a critical source for examining alternative methods of drug consumption in the non-Western world in this period: culturally embedded practices like Turkish opium eating or Native American tobacco smoking became significant benchmarks for comparing with Western habits of alcohol consumption. This article argues that the early modern Western medical community relied on comparisons of intoxication in other contexts in an effort to describe its own culturally embedded practices of alcohol intoxication.

Jean-Charles Chatelin (1884-1948), counted among the "Righteous", but forgotten as a neurologist who studied under Pierre Marie.

Charles Chatelin (1884-1948) studied under Pierre Marie (1853-1940) at hôpital La Salpêtrière and went on to a career profoundly affected by World War I. He wrote a remarkable thesis on the clinical aspects and radiography of hereditary craniofacial dysostosis, which had been recently described by Octave Crouzon (1874-1938). A few days after the publication of Georges Guillain (1876-1961) and Alexandre Barré (1880-1967), Chatelin published a comprehensive study of the eponymous syndrome. His study was prepared before that of Guillain and Barré, but only their names are remembered. After examining patients with spinal injuries, Chatelin and Pierre Marie gave the first description of what would become, in 1924, "Lhermitte's sign." The eponym was first used after this sensory symptom was added by Lhermitte to the clinical picture of multiple sclerosis. In 1915, Chatelin and Pierre Marie used a technique based on radiographic overlays to localize intracranial projectiles. They coupled this with precise examinations of the visual field of wounded soldiers, in order to map out the intra-cerebral visual pathways with accuracy. During World War II, Chatelin and his wife demonstrated their empathy by hiding a Jewish family in their home until Paris was liberated.

Eaux thermales et thermalisme en dermatologie au xixe siècle: Thermal water and hydrotherapy in xixth century dermatology.

Jean-Louis Alibert (1768-1837), Pierre-Alphée Cazenave (1802-1877) and Ferdinand von Hebra (1846-1880) are among the most famous names of the XIXth century dermatology. All were interested in hydrotherapy and mineral waters. Alibert was especially fond of sulfurous waters from the Pyrenees, for treating almost every inflammatory disease, like psoriasis, chronic eczema and even hair diseases or cheloids. He mentioned very often the use of mineral waters in his two masterpieces, Description des Maladies de la peau (1806) and Clinique de l'Hôpital Saint-Louis (1833). In case patients were not able to travel and spend times at thermal stations, he recommended artificial waters made by pharmacists in specialized places in Paris, consisting in water plus minerals, in order to obtain a composition close to natural spring waters. Around 1850, Cazenave also used mineral waters and hydrotherapy, mainly sulfurous waters. In Vienna, von Hebra was more reluctant to the use of mineral water, as he believed that the time spent in baths was more important than the composition of the water itself. Adrien Doyon (1827-1907), who translated Hebra's book in French, strongly disagreed with him, as he had a dermatology private practice in Uriage, in the French Alps. Modern hydrotherapy in dermatology is clearly in relation with this XIXth century tradition. © 2020 Elsevier Masson SAS. All rights reserved.

[About history of surgeons hidden behind our daily surgical instruments: Retractors]. / De l'histoire des chirurgiens cachés derrières nos instruments du quotidien. Partie 2 : écarteurs.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of History of Surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This second original article will focus on the inventors of modern retractors: von Langenbeck, Farabeuf, Leriche, Gillies and Tessier.

[About history of surgeons hidden behind our daily surgical instruments: Scissors]. / De l'histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 3 : ciseaux.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This third original article will focus on the inventors of modern scissors: Mayo, Metzenbaum, Stevens and Lister.

De l'histoire des chirurgiens cachés derrière nos instruments du quotidien. Partie 4 : la rhinoplastie.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This fourth original article will focus on the inventors of rhinoplasty instruments: Joseph, Killian, Aufricht, Cottle and Claoué.

[About history of surgeons hidden behind our daily surgical instruments: Forceps]. / De l'histoire des chirurgiens cachés derrières nos instruments du quotidien. Partie 1 : pinces et pincettes.

Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of History of Surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This first original article will focus on the inventors of modern forceps: Debakey, Adson, Kocher, Péan, Tuffier and Halsted.

En quête de financement pour la création d'une clinique externe et d'un service social comme parachèvement de la désinstitutionnalisation à l'Hôpital Saint-Michel-Archange de Beauport, 1961-72.

The release of the report of the Commission d'étude des hôpitaux psychiatriques (Bédard report) in 1962 was long considered a transformative moment in the history of Québec psychiatry. But recent historiography suggests that deinstitutionalization in Québec features initiatives dating back to the early 20th century. Following this line of argumentation, we suggest that the Bédard report was primarily a political tool to obtain funding in the wake of the 1961 Hospital Insurance Act, and that the report's recommendations built upon ongoing changes. This article proposes a new reading of the commission's report on Beauport's Hôpital Saint-Michel-Archange, and offers a new perspective on deinstitutionalization in Québec. Data gathered from medical records help illustrate the organizational changes that occurred between 1962 and 1972 through new public funding.

La parution du rapport de la Commission d'étude des hôpitaux psychiatriques (rapport Bédard) en 1962 fut longtemps considérée comme un point de rupture dans l'histoire de la psychiatrie québécoise. L'historiographie récente propose une nouvelle interprétation du phénomène de la désinstitutionnalisation au Québec en s'intéressant à des initiatives datant du début du 20e siècle. Dans cette perspective, nous proposons l'hypothèse que le rapport Bédard constitue un levier politique pour obtenir un financement après l'entrée en vigueur de la Loi de l'assurance-hospitalisation en 1961 et que ses recommandations s'appuient sur les changements en cours. Cet article offre une relecture du rapport de la commission en ce qui concerne l'Hôpital Saint-Michel-Archange de Beauport et jette un éclairage différent sur la désinstitutionnalisation au Québec. Pour illustrer les changements organisationnels qui se produisent entre 1962 et 1972, notamment grâce à un nouveau financement public, nous nous appuyons sur les informations contenues dans un dossier médical spécifique.

[The end of the asylum, a change in representations]. / La fin de l'asile, un bouleversement des représentations.

Through the major changes which the psychiatric hospital has undergone throughout history, the question is raised of the identity of caregivers, what the psychiatric asylum provides as a response to mental illness, and the function of the asylum as a place for receiving and then caring for patients, within society. These radical changes, which undermine the narcissism of caregivers, have consequences both within the psychiatric hospital and society as a whole. Consequences which question the very notion of care in a post-modern society.

Disappearing Acts: Anguish, Isolation, and the Re-imagining of the Mentally Ill in Global Psychopharmaceutical Advertising (1953-2005).

The visualization of mental illness has attracted substantial attention from scholars in recent decades. Due to the invisible nature of mental disorders, this work has stressed the importance of representations in shaping perceptions of mental illness. In the second half of the 20th century, advertisements for psychopharmaceutical medications became important avenues through which mental illness was made visible. This article analyzes how drug advertisements portrayed mentally ill individuals in medical journal advertisements from 14 countries between 1953 and 2005. We argue that a shift in representations occurred in the 1980s: whereas earlier campaigns were dominated by images of the mentally ill suffering in isolation, the post-1980s period was marked by a trend toward "positive" imagery, social inclusion, and ordinariness. This shift re-imagines the role of psychopharmaceuticals and who might be understood as mentally ill, reflecting changes in global marketing and the arrival of the "happiness turn" within the pharmaceutical industry.

Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study.

OBJECTIVES: To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011. METHODS: Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression. Potential risk factors were examined with multilevel logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS: 34 073 births from 1982 to 2011 were analysed. The annual rate of decrease was 0.9% for stillbirths and 1.8% for neonatal mortality. Stillbirths were associated with several risk factors: multiple births (AOR 2.57, CI 1.66-3.99), previous adverse outcome (AOR 6.16, CI 4.26-8.88) and grand multiparity among 35- to 49-year-olds (AOR 1.97, CI 1.32-2.89). Neonatal deaths were associated with multiple births (AOR 6.16, CI 4.80-7.92) and advanced maternal age linked with parity of 1-4 (AOR 2.34, CI 1.28-4.25) and grand multiparity (AOR 1.44, CI 1.09-1.90). Education, marital status and household wealth were not associated with the outcomes. CONCLUSIONS: The slow decline in mortality rates and easily identifiable risk factors calls for improving quality of care at birth and a rethinking of how to address obstetric risks, potentially a revival of the risk approach in antenatal care.

Dermatite atopíque : images hístoriques: Historical images of atopic dermatitis.

Atopic dermatitis has been described under many names before the XXth century, and first illustrated in the early XIXth century. This article presents historical images from the first volumes of Robert Willan to the Pratique dermatologique, the first encyclopedy published in 1900. Many accurate clinical descriptions of the disease can be found in the early treaties of dermatology, including the one published by Thomas Carrere in 1740. Since then, Alibert and Rayer in France, Hebra and Neumann in Vienna and Duhring and Fox in the USA illustrated their atlases with spectacular images of adults or children suffering from AD, or from other diseases that might have been considered as eczema infantile. Color engravings, color lithographs and black and white photographs showed with an increasing precision the semiology of AD, in the context of artistic representations of high quality, that have not been surpassed by modern photographs. At the beginning of the XXth century the clinical presentation, the course and heredity of the disease were perfectly established, introducing a new era of research in physiopathology and treatment in the following decades.